COST-EFFECTIVENESS ANALYSIS ON THE USE OF PARENTERAL NUTRITION WITH D10-CA GLUCONATE AND D5 1/4NS IN NORMAL-WEIGHT NEONATES WITH RESPIRATORY DISTRESS SYNDROME
Keywords:D10-CaGluconate, D5 14NS, Effectiveness, Direct medical costs, Incremental cost-effectiveness ratio
Objectives: This retrospective cohort study aimed to compare the cost-effectiveness of using D10-CaGluconate and D5 1/4NS preparations in normal weight neonatal patients with Respiratory Distress Syndrome (RDS) in Kambang General Hospital, Jambi, Indonesia.
Methods: The research was conducted from September 2014 to June 2015. The study participants were divided into two groups; D10-CaGluconate was administered to 40 patients and D5 1/4NS to 43 patients. Effectiveness was assessed based on the changes in the physical examination results, average weight gain (28.48 and 23.49 g/day), blood glucose levels (26.73 and 26.42 mg/dL), respiratory rate (-12.35 breaths/minute and -7.77
breaths/minute), pulse frequency (-10.98 and -8.07 ±), and body temperature (0.013 °C and 0.012 °C) of the patients in the D10-CaGluconate and D5 1/4NS groups, respectively.
Results: The average direct medical costs of using D10-CaGluconate and D5 1/4NS were 458,290 IDR and 408,347 IDR, respectively. The average costeffectiveness ratio value of total direct medical costs for D10-CaGluconate preparation was 35,207,467 IDR while that for D5 1/4NS was 33,958,602 IDR. The direct medical cost of the incremental cost-effectiveness ratio mean value of the D5 1/4NS preparation that compared to the D10-CaGluconate preparation was 10,017,210 IDR.
Conclusions: The parenteral nutrition preparation of D10-CaGluconate is more cost-effective than that of D5 1/4NS.
Ministry of Health Republic of Indonesia. Pedoman Penerapan Kajian
Farmakoekonomi. Jakarta: Jenderal Bina Pelayanan Kefarmasian dan
Alat Kesehatan Ministry of Health Republic of Indonesia; 2013.
Murray CJ, Knaul F, Musgrove P, Xu K, Kawabata K. Defining and
Measuring Fairness in Financial Contribution to the Health System.
Geneva: World Health Organization; 2001.
Ikatan Dokter Anak Indonesia. Pedoman Pelayanan Medis. Edisi II.
Jakarta: Ikatan Dokter Anak Indonesia; 2011.
Hermansen CL, Lorah KN. Respiratory distress in the newborn. Am
Fam Physician 2007;76(7):987-4.
Kosim MS. Buku Ajar Neonatalogi. Jakarta: IDAI; 2009.
Baron RB. Nutrition. In: Tierney LM, McPhee SI, Papadakis MA,
editors. Current Medical Diagnosis and Treatment. New York: McGraw
Edwards MO, Kotecha SJ, Kotecha S. Respiratory distress of the term
newborn infant. Paediatr Respir Rev 2013;14(1):29-36; quiz 36-7.
Frankel LR. Respiratory distress and failure. In: Kliegman R,
Behrmanq R, Jenson H, Stanton B, editors. Nelson Textbook of
Pediatrics. 18th ed. Philadelphia, PA: Sunders Elsevier; 2007. p. 421-4.
Fanaroff AA, Stoll BJ, Wright LL, Carlo WA, Ehrenkranz RA,
Stark AR, et al. Trends in neonatal morbidity and mortality for very
low birth weight infants. Am J Obstet Gynecol 2007;196(2):147.
Kusuda S, Fujimura M, Uchiyama A, Totsu S, Matsunami K. Neonatal
research network, Japan. Trends in morbidity and mortality among
very-low-birth-weight infants from 2003 to 2008 in Japan. Pediatr Res
Isayama T, Lee SK, Mori R, Kusuda S, Fujimura M, Ye XY, et al.
Comparison of mortality and morbidity of very low birth weight infants
between Canada and Japan. Pediatrics 2012;130(4):e957-65.
Gunn T, Reaman G, Outerbridge EW, Colle E. Peripheral total
parenteral nutrition for premature infants with the respiratory distress
syndrome: A controlled study. J Pediatr 1978;92(4):608-13.
Massetti M, AballÃ©a S, Videau Y, RÃ©muzat C, RoÃ¯z J, Toumi M.
A comparison of HAS & NICE guidelines for the economic evaluation
of health technologies in the context of their respective national health
care systems and cultural environments. J Mark Access Health Policy